Provider Demographics
NPI:1255523817
Name:INTEGRITY FAMILY CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:INTEGRITY FAMILY CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:VERGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-381-9680
Mailing Address - Street 1:1830 WEBSTER ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-9320
Mailing Address - Country:US
Mailing Address - Phone:715-381-9680
Mailing Address - Fax:715-381-9685
Practice Address - Street 1:1830 WEBSTER ST
Practice Address - Street 2:SUITE 130
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-9320
Practice Address - Country:US
Practice Address - Phone:715-381-9680
Practice Address - Fax:715-381-9685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4336-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty